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目的探讨人乳头瘤病毒16(HPV16)和Epstein-Barr病毒(EBV)在不同病理类型乳腺癌及乳腺良性病变中的表达。方法采用PCR方法对2013年6月至2014年6月本院收治的90例不同病理类型的乳腺癌(40例浸润性导管癌、30例浸润性小叶癌,20例原位癌)、20例乳腺纤维瘤以及10例乳腺正常组织标本HPV16的E6基因位点和EBV的内部重复序列Bam HIW区域进行扩增,并采用免疫组织化学方法对上述标本进行HPV16和EBV潜在膜蛋白(LMP-1)染色,以判断标本是否有HPV16及EBV感染,计算病毒检出率。比较不同病理类型乳腺癌的病毒检出率及比较PCR、免疫组织化学两种方法对乳腺组织标本病毒感染的检出率有无差异采用χ2检验。不同病理类型的乳腺癌标本中HPV16及EBV阳性细胞率的比较选用方差分析以及Bonferroni两两比较。结果 PCR结果显示:HPV16病毒检出率在乳腺癌标本为44.44%(40/90),乳腺纤维瘤标本为5%(1/20),正常乳腺组织为0;EBV的病毒检出率在乳腺癌标本中为43.33%(39/90),乳腺纤维瘤标本及正常乳腺组织均为0。在不同病理类型乳腺癌中,HPV16和EBV的病毒检出率差异均无统计学意义(χ2=1.238,P=0.539;χ2=1.867,P=0.393)。免疫组织化学结果显示:HPV16病毒检出率在乳腺癌标本为42.22%(38/90),乳腺纤维瘤标本为5%(1/20),正常乳腺组织为0;EBV病毒检出率在乳腺癌标本为42.22%(38/90),乳腺纤维瘤标本及正常乳腺组织均为0。有HPV16病毒感染的乳腺癌组织标本中,HPV16阳性细胞率在浸润性导管癌为(29.78±0.38)%,浸润性小叶癌为(28.31±0.53)%,原位癌为(51.83±0.65)%,3组比较差异有统计学意义(F=537.779,P=0.000);有EBV病毒感染的乳腺癌组织标本中,EBV阳性细胞率分别为(29.73±0.51)%、(28.14±0.65)%及(51.11±0.68)%,3组比较差异有统计学意义(F=427.771,P=0.000);原位癌标本中,HPV16和EBV的阳性细胞率均显著高于其他两种病理类型的乳腺癌(P均=0.000)。两种方法对乳腺癌标本HPV16及EBV的检出率差异不具有统计学意义(χ2=0.090,P=0.764;χ2=0.023,P=0.880)。结论 HPV16和EBV两种病毒的感染与乳腺癌的发生可能有一定的关系,其感染程度可能与乳腺癌的病理类型有关。
Objective To investigate the expression of human papillomavirus (HPV16) and Epstein-Barr virus (EBV) in different pathological types of breast cancer and benign breast lesions. Methods Ninety cases of breast cancer (40 invasive ductal carcinomas, 30 invasive lobular carcinomas, 20 carcinoma in situ) and 20 cases of carcinoma of the abdomen were treated by PCR in our hospital from June 2013 to June 2014. Breast fibroadenoma and 10 cases of breast normal tissue samples HPV16 E6 locus and EBV internal repeat sequence Bam HIW region amplification and immunohistochemistry of these specimens HPV16 and EBV latent membrane protein (LMP-1) Staining to determine whether the specimen HPV16 and EBV infection, calculate the detection rate of the virus. Compare the detection rate of virus in different pathological types of breast cancer and compare PCR, immunohistochemistry two methods to detect the rate of breast tissue samples virus infection whether the difference using χ2 test. Different pathological types of breast cancer specimens HPV16 and EBV-positive cell ratio comparison analysis of variance and Bonferroni pairwise comparison. Results The results of PCR showed that the detection rate of HPV16 was 44.44% (40/90) in breast cancer specimens, 5% (1/20) in breast fibroma specimens and 0 in normal breast tissues. The detection rate of EBV in breast cancer 43.33% (39/90) in cancerous specimens, and 0 in breast fibroma specimens and normal breast tissues. In different pathological types of breast cancer, there was no significant difference in the detection rates of HPV16 and EBV (χ2 = 1.238, P = 0.539; χ2 = 1.867, P = 0.393). The results of immunohistochemistry showed that the detection rate of HPV16 was 42.22% (38/90) in breast cancer specimens, 5% (1/20) in breast fibroma specimens and 0 in normal breast tissues. The detection rate of EBV virus in breast cancer Cancer specimens were 42.22% (38/90), breast fibroma specimens and normal breast tissue were 0. The percentage of HPV16-positive cells was (29.78 ± 0.38)% in infiltrating ductal carcinoma, (28.31 ± 0.53)% in invasive breast carcinoma and (51.83 ± 0.65)% in carcinoma with HPV16 infection, (F = 537.779, P = 0.000). The positive rates of EBV positive cells in EBV-infected breast cancer tissues were (29.73 ± 0.51)%, (28.14 ± 0.65)% and (51.11 ± 0.68)% respectively. There was significant difference between the three groups (F = 427.771, P = 0.000). The positive rate of HPV16 and EBV in in situ carcinoma specimens was significantly higher than that of the other two pathological types (P = 0.000). The detection rates of HPV16 and EBV between the two methods were not statistically significant (χ2 = 0.090, P = 0.764; χ2 = 0.023, P = 0.880). Conclusion The infection of HPV16 and EBV may have a certain relationship with the occurrence of breast cancer. The infection level may be related to the pathological type of breast cancer.